Lake Side Diagnostics Center, Inc.
NPI 1558550129 · Mobile Radiology Clinic/Center · Valley Glen, CA
Enrolled with Medicare as Part B Supplier - Independent Diagnostic Testing Facility (idtf) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake Side Diagnostics Center, Inc. is a Mobile Radiology Clinic/Center organization in Valley Glen, CA (NPI 1558550129).
Provider details
- NPI number
- 1558550129
- Entity type
- Organization
- Primary specialty
- Mobile Radiology Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Yevgeny Kanzburg, President(818) 985-1999
Specialties & taxonomies
Ambulatory Health Care Facilities
- Sonography Radiologic Technologist2471S1302X
Technologists, Technicians & Other Technical Service Providers
- Sonography Radiologic Technologist2471S1302X
Technologists, Technicians & Other Technical Service Providers
- Mobile Radiology Clinic/Center261QR0208X
Ambulatory Health Care Facilities
- Physiological Laboratory293D00000X
Laboratories
- Physiological Laboratory293D00000X
Laboratories
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-10-19
- Last updated
- 2022-10-26
- Certified
- 2022-10-26
Frequently asked questions
- What is Lake Side Diagnostics Center, Inc.'s NPI number?
- Lake Side Diagnostics Center, Inc.'s National Provider Identifier (NPI) is 1558550129, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Side Diagnostics Center, Inc.?
- Lake Side Diagnostics Center, Inc. is classified in the NPPES registry as Mobile Radiology Clinic/Center (Ambulatory Health Care Facilities).
- Where is Lake Side Diagnostics Center, Inc. located?
- Lake Side Diagnostics Center, Inc.'s practice location on file with NPPES is 6908 Varna Ave, Valley Glen, CA 91405-4358.
- What is Lake Side Diagnostics Center, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Lake Side Diagnostics Center, Inc. is (818) 985-1999.
- Does Lake Side Diagnostics Center, Inc. accept Medicare?
- Lake Side Diagnostics Center, Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake Side Diagnostics Center, Inc.?
- The authorized official listed on Lake Side Diagnostics Center, Inc.'s NPPES record is Yevgeny Kanzburg, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Side Diagnostics Center, Inc.'s NPI active?
- Yes — Lake Side Diagnostics Center, Inc.'s NPI (1558550129) is active in the NPPES registry as of the last update on 2022-10-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.